Individual
CALVIN K KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
119 OAKFIELD DR, BRANDON, FL 33511-5779
(813) 789-1831
(813) 689-9130
Mailing address
15102 KESTRELGLEN WAY, LITHIA, FL 33547-4820
(813) 689-0468
(813) 689-9130
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME61569
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050088691
RAILROAD MEDICARE
—
01
—
26970
BCBS
FL
05
—
379168800
—
FL
Enumeration date
12/07/2005
Last updated
07/10/2024
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